19 November 2012

Uganda: Camp Rescues Women From the Claws of Cervical Cancer

Jane Oluoch, 28, stared blankly when a physician at a free health camp hosted at Nagongera Health Centre IV in Tororo district last month, told her she had cervical cancer.

The mother of three had resigned to her fate as the ailment had gnawed at her birth canal for two years. Now recovering from an operation at Tororo Hospital, Oluoch can afford to smile: "I was distraught about leaving my children at such a tender age," she says.

Until this golden opportunity knocked, Oluoch had, for years, endured severe pain, but could not treat it due to lack of money.

"The pain would last for about five minutes. It was a terrible experience. I would abandon everything and hold my tummy," she recalls. "I would get temporary relief after a foul-smelling discharge oozed out of my vagina."

According to Dr. Frank Kyeyune, a gynaecologist at Nsambya Hospital, also the team leader of the free health camp, of over 1,800 women who turned up for the free cervical cancer screening and treatment camp, 48 were diagnosed with the disease, 19 of them at an advanced stage, while 29 were in the precancerous stage.

Cervical cancer is the leading cause of cancer-related deaths in women in Uganda. The disease affects women aged mostly between 18 and 55 years. If detected early, cervical cancer can be treated.

Unfortunately, 80% of the patients seek medical help when the disease is in its advanced stages.

Cervical cancer is caused by the human papilloma virus, which is sexually transmitted.

The World Health Organisation statistics indicate that cervical cancer affects half a million women and kills 250,000 worldwide every year.

Over 85% of cervical cancer cases and deaths occur in developing countries where effective screening, diagnosis and treatment is limited or absent.

Dr. Andrew Opete, the Tororo Hospital superintendent, explains that the disease is gradual, with symptoms visible after many years, the reason many patients do not seek medical help in time.

The early symptoms, Opete explains, include pain in the pelvic area (lower abdomen) and back, abnormal vaginal discharge, bleeding between periods or after sexual intercourse or after menopause.

The common symptom in the advanced stage is a foul-smelling vaginal discharge.

Dr. Kyeyune explains that cervical cancer can only be diagnosed using special tests, that include scooping specimens from the genitals of the infected person and scrutinise them through a microscope.

In some instances diagnosis is done using a specific microscope to look at the cervix of the victim.

"Usually the cervix of the victim would have developed grave inflammation," explains Dr. Kyeyune.

At an early stage, the ailment could be treated while at advanced stage it would require surgery to remove the cancerous tissue.

When detected at an early stage, treatment that lasts for a month would cost between sh200,000 and sh400,000. Yet in advanced stages, it would warrant a surgery, with the cost ranging from sh800,000 to sh1.2m, which many poor people cannot afford," Kyeyune explains.

Intervention measures would call for cancer screening.

However, according to Dr. David Okumu, the Tororo district health officer, the health ministry hardly posts specialised personnel to upcountry health facilities and they lack screening equipment.

Like many other hospitals, Tororo Hospital, is allotted general doctors, while specialists are retained at Mulago Hospital."This renders accessibility of specialised health services difficult," explains Dr. Okumu.

Dr. Molly Nasiima, a urologist, points at poor remuneration and conditions as one of the reasons upcountry health facilities lack specialists.

Dr. Kyeyune says there is need for the Government to develop a system to train and reward the health personnel posted to hard-to-reach areas as a way of enhancing health services in the rural poor populations."It only takes a session of specialised training in the skills required to manage such ailments," he adds.

Sarah Opendi, the state minister for health, says she is in consultation with relevant authorities in the ministry to put the suggestion into a policy. But until such an intervention is reached, cervical cancer, a preventable and treatable disease, continues to ravage the population, robbing the country of about 1,900 women every year

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